The spinal cord is composed of neurons, support cells and interwoven vascular structures that perfuse the spinal tissue. The spinal cord extends from the base of the brain, down the middle of the back, to level of the waist. The nerves that lie within the spinal cord function to carry messages back and forth from the brain to the spinal nerves located along the spinal cord. Spinal cord vascular malformations are a group of blood vessel disorders that affect the spinal cord blood supply. These are collectively called spinal cord AVMs (arteriovenous malformations)
The majority of these AVMs present with progressive neurological symptoms over several months to years. The symptoms are usually back pain associated with loss of sensation and lower extremity weakness. A small number of spinal cord AVMs present as a sudden onset of weakness, or paralysis due to bleeding within the spinal cord.
MR (magnetic resonance) imaging of the spine will usually show dilated vascular vascular channels along the dorsal cord. Spinal angiography is performed to confirm the diagnosis and identify the specific vessels supplying the malformation.
Treatment of Spinal Cord AVM
The definitive treatment of spinal AVMs is either surgery or endovascular therapy. Surgery involves performing a laminectomy (removal of bone over the spinal cord) over the area of the AVM and removing the lesion. Endovascular therapy involves placing a catheter into the AVM from the leg (the femoral artery) and injecting glue or beads into the AVM to stop its blood flow. Each spinal AVM is unique and requires an individualized treatment strategy.
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